6,809 results match your criteria treatment hyperkalaemia


Patiromer in a Patient with Severe Hyperkalemia on Incremental Hemodialysis with 1 Session per Week: A Case Report and Literature Review.

Case Rep Nephrol Dial 2021 May-Aug;11(2):158-166. Epub 2021 Jun 28.

Department of Nephrology, Central Defense Gomez Ulla Hospital, Madrid, Spain.

Hyperkalemia is common in patients with ESRD, undergoing hemodialysis (HD), and is associated with an increase in hospitalization and mortality. Residual kidney function in long-term dialysis patients is associated with lower morbidity and mortality in HD patients. Although the 2015 National Kidney Foundation-Kidney Disease Outcomes Quality Initiate (NKD-KDOQI) guidelines allow the reduction in the weekly HD dose for patients with a residual kidney urea clearance (Kur) >3 mL/min/1. Read More

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Association between the use of balanced fluids and outcomes in critically ill children: a before and after study.

Crit Care 2021 Jul 29;25(1):266. Epub 2021 Jul 29.

Division of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA.

Background: Hyperchloremia and chloride load have been associated with worse clinical outcomes in critically ill patients. We sought to evaluate the electrolyte profile and clinical outcomes associated with a unit-wide transition from saline to balanced fluids for resuscitation and maintenance fluids in a pediatric intensive care unit (PICU).

Methods: A before and after analysis of all patients admitted to the PICU in a large, urban, academic hospital between August 2018 and March 2020. Read More

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Incessant Pericarditis With Recurrent Cardiac Tamponade as the Manifestation of Autoimmune Polyglandular Syndrome Type II.

JACC Case Rep 2020 Aug 19;2(10):1536-1541. Epub 2020 Aug 19.

Cardiology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

A 23-year-old man was admitted for acute pericarditis that evolved to cardiac tamponade and shock with need of emergent pericardiocentesis and inotropic support. Corticosteroid therapy was successful, but despite a gradual tapering, the patient relapsed. Incidentally, the patient developed hyperkalemia with hyponatremia. Read More

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Hyperkalemia in Chronic Kidney Disease in the New Era of Kidney Protection Therapies.

Drugs 2021 Jul 27. Epub 2021 Jul 27.

School of Medicine, IIS-Fundacion Jimenez Diaz, University Autonoma of Madrid, FRIAT and REDINREN, Madrid, Spain.

Despite recent therapeutic advances, chronic kidney disease (CKD) is one of the fastest growing global causes of death. This illustrates limitations of current therapeutic approaches and, potentially, unidentified knowledge gaps. For decades, renin-angiotensin-aldosterone system (RAAS) blockers have been the mainstay of therapy for CKD. Read More

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Heart Failure and Chronic Kidney Disease Patients: First It Is Necessary to Act.

J Am Coll Cardiol 2021 Jul;78(4):344-347

University of Michigan School of Medicine, Ann Arbor, Michigan, USA.

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Phase 3 Study of Roxadustat to Treat Anemia in Non-Dialysis-Dependant CKD.

Kidney Int Rep 2021 Jul 17;6(7):1810-1828. Epub 2021 Apr 17.

Astellas Pharma Europe B.V., Leiden, The Netherlands.

Introduction: Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that has demonstrated safety and efficacy versus placebo in phase III trials in patients with anemia of chronic kidney disease (CKD) who were not on dialysis (NDD).

Methods: This was a phase III, active-controlled, multicenter, partially randomized, open-label study in Japanese patients with NDD CKD. Patients who had used recombinant human erythropoietin or darbepoetin alfa (DA) before conversion were randomized to roxadustat or DA (comparative arms). Read More

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Development and outcomes of hyperkalemia in hospitalized patients: potential implications for care.

Am Heart J 2021 Jul 19. Epub 2021 Jul 19.

Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota; Department of Internal Medicine, Hennepin Healthcare, and University of Minnesota, Minneapolis, Minnesota. Electronic address:

Introduction: While severe hyperkalemia is commonly encountered, its manifestation in hospitalized patients and related outcomes are unclear. We aimed to examine development of hyperkalemia in hospitalized patients and associated outcomes.

Methods: Data from a county hospital electronic health record were used to assess all inpatient admissions, 2012-2016, for non-dialysis-dependent patients with ≥1 K value for development of hyperkalemia. Read More

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Mechanisms and management of drug-induced hyperkalemia in kidney transplant patients.

Rev Endocr Metab Disord 2021 Jul 22. Epub 2021 Jul 22.

Department of Medicine, Division of Nephrology, Hypertension and Kidney Transplantation, School of Medicine, University of California, CA, Irvine, Orange, USA.

Hyperkalemia is a common and potentially life-threatening complication following kidney transplantation that can be caused by a composite of factors such as medications, delayed graft function, and possibly potassium intake. Managing hyperkalemia after kidney transplantation is associated with increased morbidity and healthcare costs, and can be a cause of multiple hospital admissions and barriers to patient discharge. Medications used routinely after kidney transplantation are considered the most frequent culprit for post-transplant hyperkalemia in recipients with a well-functioning graft. Read More

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Hyperkalemia in diabetes: newer insights into mechanism and treatment.

Postgrad Med J 2021 Jul 21. Epub 2021 Jul 21.

Nephrology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.

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The Nitty-Gritties of Kt/V Calculations in Hemodialysis and Peritoneal Dialysis.

Indian J Nephrol 2021 Mar-Apr;31(2):97-110. Epub 2021 Apr 2.

Consultant Nephrologist, Transplant Physician, Head of Department, Columbia Asia Hospital - Sarjapur Road, Ambalipura, Bengaluru, Karnataka, India.

In advanced Chronic Kidney Disease, patients require renal replacement therapy (dialysis or transplantation) for clearance of toxins, electrolyte and acid-base balance and removal of excess fluid. Dialysis adequacy should be taken into consideration in the adjustment of the dialysis prescription. Kt/V is one method of measuring dialysis adequacy that is commonly used in clinical practice. Read More

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Management of hyperkalemia in chronic heart failure using sodium zirconium cyclosilicate.

Clin Cardiol 2021 Jul 15. Epub 2021 Jul 15.

Second Department of Internal Medicine, University of Toyama, Toyama, Japan.

Background: Sodium zirconium cyclosilicate (SZC), a newly-developed selective potassium binder, has been clinically available to treat hyperkalemia. SZC might be a promising option to manage hyperkalemia, particularly in patients with heart failure, who often require potassium-sparing medications. However, the optimal initial dose of SZC therapy at a loading dose (30 g per day for the initial 2 days) versus a maintenance dose (5 g per day) remains unknown. Read More

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Isolated Adrenocorticotropic Hormone Deficiency Associated with Severe Hyperkalemia During Pembrolizumab Therapy in a Patient with Ureteral Cancer and an Ileal Conduit: A Case Report and Literature Review.

Am J Case Rep 2021 Jul 15;22:e931639. Epub 2021 Jul 15.

Department of Urology, Uonuma Kikan Hospital, Minamiuonuma, Niigata, Japan.

BACKGROUND Immune checkpoint inhibitors (ICIs) are anticancer medications that enhance the antitumor immune response. The clinical benefit afforded by ICIs, however, can be accompanied by immune-related adverse events (IRAEs). One of the common endocrine IRAEs is hypophysitis, which often causes hypopituitarism with secondary adrenal insufficiency (AI). Read More

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Preventing microalbuminuria with benazepril, valsartan, and benazepril-valsartan combination therapy in diabetic patients with high-normal albuminuria: A prospective, randomized, open-label, blinded endpoint (PROBE) study.

PLoS Med 2021 Jul 14;18(7):e1003691. Epub 2021 Jul 14.

Department of Renal Medicine, Clinical Research Center for Rare Diseases, "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Bergamo, Italy.

Background: Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) prevent microalbuminuria in normoalbuminuric type 2 diabetic patients. We assessed whether combined therapy with the 2 medications may prevent microalbuminuria better than ACE inhibitor or ARB monotherapy.

Methods And Findings: VARIETY was a prospective, randomized, open-label, blinded endpoint (PROBE) trial evaluating whether, at similar blood pressure (BP) control, combined therapy with benazepril (10 mg/day) and valsartan (160 mg/day) would prevent microalbuminuria more effectively than benazepril (20 mg/day) or valsartan (320 mg/day) monotherapy in 612 type 2 diabetic patients with high-normal albuminuria included between July 2007 and April 2013 by the Istituto di Ricerche Farmacologiche Mario Negri IRCCS and 8 diabetology or nephrology units in Italy. Read More

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Specific disruption of calcineurin-signaling in the distal convoluted tubule impacts the transcriptome and proteome, and causes hypomagnesemia and metabolic acidosis.

Kidney Int 2021 Jul 9. Epub 2021 Jul 9.

Institute of Anatomy, University of Zurich, Zurich, Switzerland;; Swiss National Centre for Competence in Research "Kidney Control of Homeostasis", Zurich, Switzerland. Electronic address:

Adverse effects of calcineurin inhibitors (CNI), such as hypertension, hyperkalemia, acidosis, hypomagnesemia and hypercalciuria, have been linked to dysfunction of the distal convoluted tubule (DCT). To test this, we generated a mouse model with an inducible DCT-specific deletion of the calcineurin regulatory subunit B alpha (CnB1-KO). Three weeks after CnB1 deletion, these mice exhibited hypomagnesemia and acidosis, but no hypertension, hyperkalemia or hypercalciuria. Read More

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The Non-Steroidal Mineralocorticoid Receptor Antagonist KBP-5074 Limits Albuminuria and has Improved Therapeutic Index Compared With Eplerenone in a Rat Model With Mineralocorticoid-Induced Renal Injury.

Front Pharmacol 2021 24;12:604928. Epub 2021 Jun 24.

KBP BioSciences USA Inc., Princeton, NJ, United States.

The therapeutic indices (TIs) and efficacy of the non-steroidal mineralocorticoid receptor antagonist (MRA) KBP-5074 and steroidal MRA eplerenone were evaluated in a uninephrectomized Sprague Dawley rat model of aldosterone-mediated renal disease. In two parallel studies, rats were placed on a high-salt diet and received aldosterone by osmotic mini-pump infusion over the course of 27 days. The urinary albumin-to-creatinine ratio (UACR) was evaluated after 7, 14, and 26 days of treatment. Read More

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Treatment of Mild Hyperkalemia in Hospitalized Patients: An Unnecessary Practice?

Can J Hosp Pharm 2021 1;74(3):269-276. Epub 2021 Jul 1.

, MD, FRCPC, is with the Department of Nephrology, Horizon Health Network, New Brunswick, and the Department of Medicine, Dalhousie University, Halifax, Nova Scotia.

Background: Sodium polystyrene sulfonate (SPS) is one of the most commonly used treatments for mild hyperkalemia. Other treatments include insulin, sodium bicarbonate, and salbutamol, which may be given alone or in combination. The results of research examining treatment effectiveness for mild hyperkalemia (e. Read More

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Minimal Change Disease With Severe Acute Kidney Injury Following the Oxford-AstraZeneca COVID-19 Vaccine: A CASE Report.

Am J Kidney Dis 2021 Jul 6. Epub 2021 Jul 6.

Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Quebec, Canada. Electronic address:

We report a CASE of minimal change disease (MCD) with severe acute kidney injury (AKI) following the first injection of the ChAdOx1 nCoV-19/AZD1222 vaccine (Oxford-AstraZeneca). A 71-year-old man with history of dyslipidemia and a baseline serum creatinine of 0.7 mg/dl presented with nephrotic syndrome, AKI, and severe hypertension 13 days after receiving the Oxford-AstraZeneca vaccine. Read More

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Hypokalemic Periodic Paralysis Precipitated by Thyrotoxicosis and Renal Tubular Acidosis.

Case Rep Endocrinol 2021 21;2021:4529009. Epub 2021 Jun 21.

Department of Pulmonary and Critical Care, Creighton University School of Medicine, Omaha, NE, USA.

Background: Hypokalemic periodic paralysis is a rare neuromuscular disorder characterized by transient episodes of flaccid paralysis due to a defect in muscle ion channels. Most cases are hereditary, but it can be acquired. We present a case of acquired hypokalemic periodic paralysis associated with hyperthyroidism and renal tubular acidosis. Read More

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Prognostic implications of hypo and hyperkalaemia in acute heart failure with reduced ejection fraction. Analysis of cardiovascular mortality and hospital readmissions.

Med Clin (Barc) 2021 Jul 3. Epub 2021 Jul 3.

Unidad de Insuficiencia Cardíaca y Trasplante, Hospital Universitari i Politècnic La Fe, Valencia, España; Servicio de Cardiología, Hospital Universitari i Politècnic La Fe. Valencia, España; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Valencia, España; Facultad de Medicina, Universidad de Valencia, Valencia, España.

Background And Objectives: Potassium alterations constitute a major clinical problem in decompensated heart failure (HF). This study aims to assess the prognostic implications of hypo and hyperkalaemia on admission for acute HF in cardiovascular mortality and hospital readmissions.

Material And Method: From January 2016 to June 2020, 1,397 cases with a diagnosis of acute HF were admitted. Read More

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The LIFT trial: study protocol for a double-blind, randomised, placebo-controlled trial of K-binder Lokelma for maximisation of RAAS inhibition in CKD patients with heart failure.

BMC Nephrol 2021 Jul 6;22(1):254. Epub 2021 Jul 6.

St George's University Hospitals NHS Foundation Trust, London, UK.

Background: CKD is common in heart failure (HF) and associated with morbidity and mortality, yet life-prolonging medications such as renin-angiotensin-aldosterone inhibitors (RAASi) are underused due to risk of hyperkalaemia. Sodium zirconium cyclosilicate (SZC) is a potassium-binding medication that has been shown to reduce incidence of hyperkalaemia in CKD, non-CKD, and HF populations, which we propose will support maximisation of RAASi therapy.

Methods: We propose a 1:1 randomised, double-blind, placebo-controlled trial in which participants will receive either SZC or placebo. Read More

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Sodium zirconium cyclosilicate for the management of chronic hyperkalemia in kidney disease, a novel agent.

Expert Rev Clin Pharmacol 2021 Jul 6:1-10. Epub 2021 Jul 6.

Division of Nephrology, University of Illinois at Chicago, Chicago, USA.

Introduction: Hyperkalemia is a common finding in patients with advanced kidney disease for multiple reasons. Renin-Angiotensin-Aldosterone-System Inhibitors (RAASi) that are indicated for slowing down progression of kidney disease are often associated with hyperkalemia which becomes a limiting factor in their use and titration to the maximum dose. Having a safe, effective, tolerable, and affordable potassium binder can help optimize RAAS inhibition in the setting of kidney disease. Read More

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Ibuprofen-associated minimal change disease and acute interstitial nephritis with possibly linked membranous glomerulonephritis.

SAGE Open Med Case Rep 2021 21;9:2050313X211025145. Epub 2021 Jun 21.

Division of Nephrology and Hypertension and Kidney Transplantation, Department of Medicine, University of California, Irvine, Irvine, CA, USA.

Non-steroidal anti-inflammatory drugs are not only potent analgesics and antipyretics but also nephrotoxins, and may cause electrolyte disarray. In addition to the commonly expected effects, including hyperkalemia, hyponatremia, acute renal injury, renal cortical necrosis, and volume retention, glomerular disease with or without nephrotic syndrome or nephritis can occur as well including after years of seemingly safe administration. Minimal change disease, secondary membranous glomerulonephritis, and acute interstitial nephritis are all reported glomerular lesions seen with non-steroidal anti-inflammatory use. Read More

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Evaluation of potential drug interactions with sodium zirconium cyclosilicate: a single-center, open-label, one sequence crossover study in healthy adults.

Clin Kidney J 2021 Jul 29;14(7):1808-1816. Epub 2020 Dec 29.

Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, Research and Development, AstraZeneca, Gaithersburg, MD, USA.

Background: Sodium zirconium cyclosilicate (SZC; formerly ZS-9) is an oral potassium binder for the treatment of hyperkalemia in adults. SZC acts in the gastrointestinal tract and additionally binds hydrogen ions in acidic environments like the stomach, potentially transiently increasing gastric pH and leading to drug interactions with pH-sensitive drugs. This study assessed potential pharmacokinetic (PK) interactions between SZC and nine pH-sensitive drugs. Read More

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Reverse pseudohyperkalemia is more than leukocytosis: a retrospective study.

Clin Kidney J 2021 May 7;14(5):1443-1449. Epub 2020 Sep 7.

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Hyperkalemia is a potentially life-threatening electrolyte abnormality that often requires urgent treatment. Clinicians should distinguish true hyperkalemia from pseudohyperkalemia and reverse pseudohyperkalemia (RPK). RPK has exclusively been described in case reports of patients with hematologic malignancies (HMs) and extreme leukocytosis [white blood cell (WBC) count >200 × 10/mL]. Read More

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Effect of intestinal dialysis using polyethylene glycol on fluid balance and thirst in maintenance hemodialysis patients: A comparative study.

Ther Apher Dial 2021 Jul 4. Epub 2021 Jul 4.

Department of Nephrology, KG Hospital and PG Institute, Coimbatore, Tamil Nadu, India.

High inter-dialytic weight gains (IDWG) and Hyperkalemia have been associated with adverse outcomes like poor quality of life and high mortality. Thirst remains an unsolved problem in hemodialysis (HD) patients. The aim of this study was to evaluate the effect of polyethylene glycol (PEG) based intestinal dialysis on IDWG, thirst and biochemical parameters. Read More

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A Rare Case of Spontaneous Tumor Lysis Syndrome in Hodgkin Lymphoma.

Cureus 2021 Jun 24;13(6):e15887. Epub 2021 Jun 24.

Internal Medicine, Leidos QTC Healthcare Services, Phildelphia, USA.

Tumor lysis syndrome (TLS) is an oncological emergency characterized by biochemical abnormalities such as metabolic acidosis, hyperkalemia, hyperphosphatemia, and hypocalcemia. The clinical outcome is directly related to the biochemical abnormalities. TLS can occur in any malignancy, but it is highly associated with rapidly proliferating tumors. Read More

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Organoprotective Effects of Spironolactone on Top of Ramipril Therapy in a Mouse Model for Alport Syndrome.

J Clin Med 2021 Jun 30;10(13). Epub 2021 Jun 30.

Clinic of Nephrology and Rheumatology, University Medical Center Goettingen, 37075 Goettingen, Germany.

Angiotensin-converting enzyme inhibitors (ACEi) delay progression of the inherited renal disease Alport syndrome. However, the effect of ACEis weakens gradually due to an "aldosterone escape". Here, we investigate if an aldosterone antagonist can counteract loss of ACEi-efficacy. Read More

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Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease.

Pharmaceuticals (Basel) 2021 Jun 11;14(6). Epub 2021 Jun 11.

Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.

Diabetes mellitus is a global health issue and main cause of chronic kidney disease. Both diseases are also linked through high cardiovascular morbidity and mortality. Diabetic kidney disease (DKD) is present in up to 40% of diabetic patients; therefore, prevention and treatment of DKD are of utmost importance. Read More

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Stopping mineralocorticoid receptor antagonists after hyperkalaemia: trial emulation in data from routine care.

Eur J Heart Fail 2021 Jul 1. Epub 2021 Jul 1.

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Aims: Whether to continue or stop mineralocorticoid receptor antagonists (MRA) after an episode of hyperkalaemia is a challenge in clinical practice. While stopping MRA may prevent recurrent hyperkalaemias, it deprives patients of their cardioprotection. We here assessed the association between stopping vs. Read More

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Combination Therapy Using Sodium Zirconium Cyclosilicate and a Mineralocorticoid Receptor Antagonist in Patients with Heart Failure and Hyperkalemia.

Intern Med 2021 1;60(13):2093-2095. Epub 2021 Jul 1.

The Second Department of Internal Medicine, University of Toyama, Japan.

Hyperkalemia is a challenging comorbidity to manage in patients with heart failure and chronic kidney disease, particularly when administering renin-angiotensin-aldosterone system inhibitors. We encountered an 88-year-old woman with hypertensive heart failure and chronic kidney disease. A mineralocorticoid receptor antagonist was able to be safely administered despite persistent hyperkalemia when sodium zirconium cyclosilicate, a non-absorbed, non-polymer zirconium silicate compound that preferentially exchanges hydrogen and sodium for potassium and ammonium ions in the gastrointestinal tract, was concomitantly administered. Read More

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